Filler Nostalgia

In praise of on call?

BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7155.375 (Published 08 August 1998) Cite this as: BMJ 1998;317:375
  1. Chris Gunstone, general practitioner
  1. Burton upon Trent

    My not too long retired senior partners can recall clashing forceps and chloroform in the back streets of Burton. As I am gently eased out of time consuming obstetric care I sense a vague feeling of disquiet.

    I have spent this bank holiday on call. I have been working in an urban 10 000 patient practice for the past 10 years. During the 24 hours I saw 16 patients—a few more than usual perhaps, but I knew all of them or members of their family. Seeing people in their home surroundings can help build up the jigsaw pattern that makes their lives. Knowing and respecting the person makes even the diagnosis of a viral illness a pleasant interaction.

    Some of the on call pleasures are more indirect—seeing the occasional fox on an early morning call, the silence of normally busy roads, the clarity of the night sky, or seeing the fading Hale- Bopp when driving down country roads to that patient we ought to have removed from the list some time ago.

    Sometimes I cast longing eyes at the local cooperative—but for the time being we are preserving the old custom. Perhaps in the 21st century, when we have all been pleasantly eased out of our 24 hour commitment, we will look back to on call as a quaint custom of the 1990s. I wonder if we will feel any pang of disquiet? In the sterile nine to five office based general practice of the future, we may feel that we have lost some of the magic that makes the discipline such a wonderful career.

    We welcome articles up to 600 words on topics such as A memorable patient, A paper that changed my practice, My most unfortunate mistake,or any other piece conveying instruction, pathos, or humour. If possible the article should be supplied on a disk. Permission is needed from the patient or a relative if an identifiable patient is referred to. We also welcome contributions for “Endpieces,” consisting of quotations of up to 80 words (but most are considerably shorter) from any source, ancient or modern, which have appealed to the reader.

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